穴位埋线法治疗中风后便秘:多中心随机对照研究  

Post-stroke constipation treated with acupoint embedding therapy: a multi-center randomized controlled trial

作　　者：杜嘉[1] 刘昊 许静 陆春梅 周金凤[4] 吴平花 郑丽圆 李新伟[1] DU Jia;LIU Hao;XU Jing;LU Chun-mei;ZHOU Jin-feng;WU Ping-hua;ZHENG Li-yuan;LI Xin-wei(Department of Acupuncture-Moxibustion and Tuina,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China;Zhejiang Provincial Tiantai County Hospital of TCM;Qinshan Street Community Health Service Center of Haiyan County;Zhejiang Provincial Haiyan County Hospital of TCM;Gongshu District Mishixiang Street Community Health Service Center of Hangzhou City,Zhejiang Province;Yuhang District Wuchang Street Community Health Service Center of Hangzhou City,Zhejiang Province)

机构地区：[1]浙江省立同德医院针灸推拿科,杭州310012 [2]浙江省天台县中医院 [3]浙江省海盐县秦山街道社区卫生服务中心 [4]浙江省海盐县中医院 [5]浙江省杭州市拱墅区米市巷街道社区卫生服务中心 [6]浙江省杭州市余杭区五常街道社区卫生服务中心

出　　处：《中国针灸》2020年第5期493-497,共5页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科技计划项目:2017ZT001。

摘　　要：目的:验证穴位埋线法治疗中风后便秘的临床疗效。方法:采用多中心随机对照临床试验,将210例中风后便秘患者分为埋线组(105例,脱落4例)和假埋线组(105例,脱落6例)。埋线组予穴位埋线治疗,穴取天枢、大横、下脘、中脘、气海、关元、大巨;假埋线组采用假穴位埋线法,取穴、针具、操作均同埋线组,但针管里未装入可吸收性外科缝线。两组均2周埋线1次,共埋线4次。比较两组治疗期间(第3~8周)周平均完全自主排便次数(CSBMs),及治疗前后周平均自主排便次数(SBMs)、Bristol粪便性状评分、便秘患者生活质量量表(PAC-QOL)评分和排便困难程度评分。结果:埋线组患者周平均CSBMs≥3次的病例数所占百分比明显高于假埋线组[91.1%(92/101)vs 43.4%(43/99),P<0.01]。与治疗前比较,两组患者治疗后周平均SBMs、Bristol粪便性状评分均明显增加(P<0.01),PAC-QOL量表评分、排便困难程度评分均明显降低(P<0.01);埋线组治疗后周平均SBMs与Bristol粪便性状评分增加幅度、PAC-QOL量表与排便困难程度评分降低幅度均大于假埋线组(P<0.05)。结论:穴位埋线法可以明显增加中风后便秘患者的自主排便次数,改善粪便性状和排便困难程度,提高其生活质量。Objective To verify the clinical effect of acupoint embedding therapy on post-stroke constipation. Methods The multi-central randomized controlled trial was adopted. 210 patients of post-stroke constipation were divided into an acupoint embedding group(105 cases, 4 cases dropped off) and a sham-embedding group(105 cases, 6 cases dropped off). In the acupoint embedding group, the acupoint embedding therapy was used at Tianshu(ST 25), Daheng(SP 15), Xiawan(CV 10),Zhongwan(CV 12), Qihai(CV 6), Guanyuan(CV 4) and Daju(ST 27). In the sham-embedding group, the sham-embedding therapy was given, in which, the acupoint selection, needle devices and manipulation were the same as the acupoint embedding group. But, no absorbable surgical suture was used in the needle tube. The treatment was given once every two weeks and 4 treatments were required in either group. It was to compare the weekly average complete spontaneous bowel movements(CSBMs) during treatment(from the 3 rd to the 8 th week) between the two groups, the weekly average spontaneous bowel movements(SBMs), Bristol stool form score(BSFS), the score of the patient assessment of constipation quality of life questionnaire(PAC-QOL) and the score of defecation difficulty before and after treatment. Results The percentage of the cases with weekly average CSBMs ≥ 3 times in the patients of the acupoint embedding group was higher markedly than the sham-embedding group [91.1%(92/101) vs 43.4%(43/99), P<0.01]. Compared with the values before treatment, the weekly average SBMs and BSFS scores after treatment were all increased obviously in the two groups(P<0.01), and PAC-QOL score and the score of defecation difficulty were reduced remarkably(P<0.01). After treatment, the increase range of SBMs and BSFS scores, as well as the decrease range of PAC-QOL score and the defecation difficulty score in the acupoint embedding group were all higher than the sham-embedding group respectively(P<0.05).Conclusion The acupoint embedding therapy remarkably increases the spontaneous bowel

关 键 词：中风后便秘 穴位埋线 完全自主排便次数 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]